Individual provider Active NPI

Teresa A. Beelen, O.D.

  • Optometrist
  • Battle Creek, MI
National Provider Identifier
1316900160
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901004861 Issued in MI
Practice address
12765 Harper Village Dr Ste 107
Battle Creek, MI 49014-8376
Phone
(269) 979-2832
Fax
(269) 979-2855
NPI assigned
Apr 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X O.D.#455D.P.A.143 PR
Optometrist 152W00000X 4901004861 MI Primary

Addresses

Primary practice location

12765 Harper Village Dr Ste 107
Battle Creek, MI 49014-8376

Mailing address

194 Black Cherry LN
Battle Creek, MI 49015-7609
Phone (269) 245-7926

Other identifiers 1

IdentifierTypeStateIssuer
65226-006OtherMIDAVIS VISION

Other names 1

  • Teresa Amelia Beelen Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160121001057 MI Practitioner - Optometry 1658321336 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901004861MIMDOptometrist
O.D.#455D.P.A.143PRMDOptometrist
455PRMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hiemstra Optical Company CurrentSince Jun 1, 2024 Accepting new patients
Mid Michigan Eye Care Center, PC Optometrist Current Accepting new patients
Intermed Primary Care Past Accepting new patients
America'S Best Contacts & Eyeglasses PastSince Mar 13, 2022 Accepting new patients
Lansing Ophthalmology, P.C. Optometrist Past Accepting new patients

Locations

133 E Michigan Ave
Paw Paw, MI 49079
Phone (269) 657-7288

102 N Main St
Ste B
Plainwell, MI 49080
Phone (269) 685-9511

255 Romence Rd
Portage, MI 49024
Phone (269) 324-0800

6880 W Snowville Rd
Ste 215
Brecksville, OH 44141
Phone (440) 526-1974

Interoperability endpoints

  • Direct secure messaging: tbeelen@sei.intellechartdirect.net

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1316900160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 BLACK CHERRY LN",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490157609",
            "telephone_number": "269-245-7926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12765 HARPER VILLAGE DR STE 107",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490148376",
            "telephone_number": "269-979-2832",
            "fax_number": "269-979-2855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEELEN",
        "first_name": "TERESA",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-11",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "O.D.#455D.P.A.143",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "65226-006",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "BEELEN",
            "middle_name": "AMELIA",
            "credential": "O.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Battle Creek, MI

Sources for this page

Verify at the official NPI Registry.